This invention relates to a technique of accounting for the presence of medical equipment that is placed in intimate contact with a patient's tissues, such a urinary catheter or other indwelling catheter in a hospital patient, and is more specifically concerned with a technique that permits scanning of the patient with a scanning device for that purpose. The invention is more specifically concerned with a technique for indicating the presence or absence of a catheter, the term “catheter” to including an IV tube, a wound dressing, or other item that can create a source of a hospital-acquired infection if the device remains in contact with a hospital patient for an extended period. The invention is also concerned with techniques for maintaining a log of patients with catheters and of the time and date when the catheters are scheduled to be removed.
The invention is more particularly concerned with a technique that employs an identification tag, e.g., uniquely coded radio frequency identity (RFID) chips or tags and one or more RFID scanners adapted to track the use of the catheters. For some applications, an alternative identification tag may be used, such as a mag stripe, a two-dimensional bar code or a one-dimensional bar code.
Hospital-acquired infections of patients, at the current time, are a major problem in medicine, both as a significant drawback to patient care, and also as a significant cost to hospitals, a cost which is not reimbursable. Urinary tract infection, or UTI, is the most common hospital-acquired infection, and UTIs have been linked to the use of urinary catheters. Urinary catheters can serve as an example of an application of this invention, but other catheters or catheter related devices present similar problems. At present, one in four hospitalized patients is fitted with a urinary catheter. Each year, urinary catheters trigger a half million or more cases of urinary tract infection. However, many patients do not require catheters, and many others do not need them beyond a day or two of their hospitalization. Urinary catheters are often ordered only as a precaution after some types of surgeries. Hospitals do not have any reliable system to track catheter use, and many hospitals do not keep track of which patients have catheters. It is estimated that only about one in ten hospitals conducts a daily check of the patient to see if continued catheter use is needed. As a result,] a large share of hospital patients have catheters for several days longer than is necessary, and this extended use of urinary catheters leads to UTIs. About one percent of the patients administered a urinary catheter will get a urinary tract infection. All of those patients will require antibiotics, and some of them at least will suffer life-threatening complications.
The added cost of treating a patient for a hospital-acquired urinary tract infection is significant. Each episode of symptomatic nosocomial UTI costs at least $600, and each episode of UTI-related bloodstream infection results in even higher costs, conservatively at least $2,800. The problem is compounded in that many infections are asymptomatic, and patients can be administered an antibiotic simply for the reason that they have an indwelling catheter. The administration of an antibiotic can be inappropriate, as it can enable the infectious organisms to become multi-drug resistant, and very difficult to treat later on.
Moreover, many third-party payers, e.g., health insurance plans, do not or will no longer reimburse hospitals for hospital-acquired preventable complications. Medicare has instituted a “Never Events” policy, and will no longer pay for various preventable hospital errors, including not only surgical errors and injuries from falls, but also catheter-related urinary tract infections. The hospital cannot bill the injured patients for the added costs of treatment. The only recourse is for the medical practicioners to ensure the catheter is not left in when it is not needed.
Catheters are widely used even though need for urinary catheters is often unjustified and is unnecessary for most patients for about one-third of the days that the patients are catheterized. Moreover, the treating physician can often be completely unaware that a catheter is in place. A majority of hospitals do not monitor for catheter duration. As a result, the physicians are not writing orders to have the catheters removed, even when they are unnecessary or no longer necessary. It has thus become incumbent on the patient, or the patient's family, to ask the doctor or nurse, every day, whether the catheter is still really necessary or if it can be removed, but the patient or his or her family does not know they should do this, and it should not be the patient's burden to have to remind the doctor or nurse about the catheter.
In the past, some steps have been taken to reduce the incidence of catheter-related UTI. These include the use of catheters that are coated with an anti-bacterial agent to inhibit bacterial growth, or the use of an anti-microbial agent in the urine collection bag. However, these have not proven to be effective in reducing UTI. Other techniques involve using condom-style catheters, which at least reduce the risk of bacteria entering the urethra, or supra-pubic catheters, but the latter involves actually having to penetrate the abdomen and bladder of the patient, and can result in complications. Portable ultrasound bladder scanners can be used to see if the patient's bladder is being emptied without a catheter, but most hospitals do not use that system on any regular basis.
Accordingly, some simple technique is needed to identify those patients that have an indwelling catheter such as urinary catheter, to track the time of use of the catheter, and to ensure that the catheter is not left in place any longer than necessary. By removing the catheter as soon as it is no longer needed, the major cause of hospital-caused UTI will be avoided, and the cost and medical risk involved in hospitalization will be reduced significantly. The problems of this nature are not limited to urinary catheters. This technique can also be used for any other indwelling catheter, or to the use of catheter related devices or catheter-like devices That is, the invention can be used in situations where the use of a device that is in intimate contact with patient tissues heeds to be monitored, and the length of use of the device needs to be limited or controlled. This extends then to intravenous devices, including needles and tubes and also IV administrative sets and their associated tubing, in order to limit the possibility of septicemia or blood poisoning.